Revisional Bariatric Surgery

Surgical Procedures

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Sometimes patients who have undergone prior bariatric surgery experience persistent or recurrent weight issues, acid reflux, bile reflux, nausea, vomiting, or other complications. These patients may be candidates for surgical revision and are always assessed on an individual basis during consultation.

Revision surgery falls into three general categories:

Persistent or Recurrent Obesity

For patients who did not achieve adequate weight loss or have experienced significant weight regain:

  • Lap Band to Sleeve, SADI-S, or Duodenal Switch
  • Sleeve to SADI-S or Duodenal Switch
  • SADI-S to Duodenal Switch

Acid Reflux

Severe or worsening acid reflux after bariatric surgery is often best addressed by converting to a Roux-en-Y Gastric Bypass, which eliminates acid exposure to the esophagus. Options include:

  • Lap Band to Bypass
  • Sleeve to Bypass
  • SADI-S to Bypass
  • Duodenal Switch to Bypass
  • Hiatal Hernia Repair to Bypass
  • Bypass with addition of truncal vagotomy
  • Repair of recurrent or new hiatal hernia

Bile Reflux

Bile reflux is most commonly seen following SADI-S and can be addressed by converting to a full Duodenal Switch, which separates bile from the digestive tract more completely:

  • SADI-S to Duodenal Switch
  • Sleeve to Duodenal Switch

Revisional surgery does carry higher risk of leak at the staple lines as well as increased risk of injury to surrounding structures due to scar tissue from prior surgery. Risks, benefits, and alternatives are always discussed at the time of consultation.